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Ethics in Health Education
Dr. Peter Holub,
DPM., MS.
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There is an old political joke about proposing
a constitutional amendment requiring anyone who won an election to serve a
prison term before taking office…in order to save time!
Considering the increasing number of reports
on unethical conduct in health care, some might argue that providers and
researchers might do the same. In a recent study of medical schools
conducted by Papadakis, et al., it was found that physicians who
were disciplined by state medical licensing boards were up to eight times as
likely to have displayed unprofessional behavior in medical school.1
The authors of this study suggest that schools need to emphasize both
patient care and professionalism across the entire curriculum in order to
improve professional behavior and reduce disciplinary action.
As a college professor in the health sciences, I sometimes wonder who amongst
the fold will one day get in trouble for compromising principles of nonmaleficence or beneficence. Will it be the student with a lame excuse for
turning his work in late? Will it be the one who turned in the same paper he
submitted last year for another class? Will the students in the bottom half
of the class have a greater temptation to stray than those in the top half?
Or, are those top students too shrewd to be caught?
How much of their unethical behavior can be blamed on me, their mentor, for
failing to teach them the value of a virtuous life? Everyone knows that
cheating or hurting others is wrong. Why even bother formalizing an
education in health care ethics? Shouldn’t it be enough that we have laws
that forbid irresponsible behavior?
Although laws may deter some unethical actions, not all unethical behavior
is illegal. Whereas legal dilemmas seldom exist (if the light is red, I
break the law by failing to stop), ethical dilemmas occur when there is no
obvious right or wrong behavior. That doesn’t mean there is no right or
wrong answer, just that the issues concerned require further examination.
I am glad to see research supporting the value of ethics as a core
competency in health education and believe it should be a central theme in
every course. Professionalism is a learned human behavior, but it is not
guaranteed by a wall covered with diplomas. We cannot assume ethical
behavior is “inherent” or that students will learn it later on the job.
Considering the increasing diversity of health care students, it is not
realistic to presume that they are able to guess what kind of behavior is
expected of them.
In fact, one of the reasons allied health and
nursing students are attending class is to learn how to become a
professional in the health community. While colleges are not often
considered the “real world,” they are the real world of academia and have
the responsibility to prepare students for the real world of healthcare.
This includes helping students understand which behaviors are acceptable and
which behaviors are not.
Email your responses to me at
holub@nsu.nova.edu.
Papadakis, M., Teherani, A., Banach, M.A., Knettler, T.R., Rattner, S.L.,
Stern, D.T., Veloski, J. J., & Hodgson, C.S. (2005). Disciplinary action by
medical boards and prior behavior in medical school [Electronic version].
The New England Journal of Medicine, 353(25), 2673 - 2682.
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